New reconstruction tools in acute stroke: time-, contrast material-, and dose-saving together with better diagnostic value

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This study aimes to develop an reconstruction algorithm that is able to calculate the necessary and additional information about an acute stroke from a single dual energy CTA. This may lead to a time-, radiation dose- and contrast material saving and could have a high impact on the acute treatment of stroke patients. We plan three steps (milestones) to reach this aim:First we do not need to establish a save diagnostic protocoll because we have it already. But we need to acquire the data propectively in this first phase of the study. We will prospectively collect the data that will be acquired during clinical routine for 3 months including a standard Dual-Energy CTA. According to the german guidelines for stroke patients an additional native CT scan of the brain will be done. The scan and the procedures around are equal to our standard treatment. The study does not have any impact on pateint´s treatment or therapeutic decisions.Second we will reconstruct virtual images out of the regularly acquired CT data: We use the data to reconstruct virtual native CT scans that will be able to exclude an intracranial bleeding. Additionally we will try to develop an algorithm that is able to visualize the distribution of the contrat material in the ischemic and non-ischemic areas of the brain parenchyma. These datasets might be able to visualize the acute stroke during the acute phase and would be an enormous step forward in acute stroke imaging. this would additionally save contrast material and radiation dose and -in this emergency setting- also shorten the time from between diagnostics and therapy.Establishing a new diagnostic procedure:The last aim is to establish a new diagnostic procedure for acute stroke patients. It is absolutely necessary that this study will never have an impact on the guideline accordance of diagnostic and treatment. For evaluating the diagnostic accurancy we need at least 100 datasets that will be acquired over 2 years propectively. This prosepctive data acquisition will not be randomised because there is no ethically acceptable diagnostic or therapeutical alternative.